Updated August 21, 2020.
Medicare Annual Enrollment is a valuable opportunity to re-evaluate your Medicare plan, review Medicare options, and even find a better plan. The Annual Enrollment Period for coverage during 2021 runs October 15th through December 7th.
Preparing for Annual Enrollment can help you take full advantage of this opportunity to make sure that your Medicare plans meet your needs. Here are three things you can do to be ready for this year’s Annual Enrollment Period:
“People should prepare for Medicare Annual Enrollment by reviewing their health care utilization this past year and thinking about anticipated utilization and needs for the coming year,” advises Gayle Byck, PhD, Board Certified Patient Advocate, Certified Senior Advisor®, and founder of InTune Health Advocates, LLC.
Understanding what you spent on health care this year can help you project costs for next year. As you think about how much your health plan costs, be sure to include the monthly premiums and all out-of-pocket expenses. Out-of-pocket expenses are the costs you paid for prescriptions, doctor visits, and treatment.
While you’re evaluating this year’s costs, it’s important to consider how well your current plan met your coverage needs. While it can be less work to stay on the same plan, it’s not worth staying if there are cheaper options that offer better coverage.
Byck recommends considering this question as you evaluate your current plan:
As you evaluate the total cost of your plan and other health plans you are considering, include the monthly premiums and all out-of-pocket expenses. It’s important to do this in-depth analysis, especially if you’re considering switching between Original Medicare and a Medicare Advantage plan.
While this kind of evaluation can be tedious and time-consuming, it’s worth it. If you’re living on retirement savings, you only have a certain amount that you can spend. It’s important to find the most cost-effective plan with the coverage you need to make your retirement savings last as long as possible.
Medicare Advantage and Medicare Part D (Prescription Drug Plans) change every year. Additionally, companies offer new plans. There are a couple of important things to research about your current plan and for any new plan you consider:
Make sure you know how your plans are changing by doing your own research. There are several great resources to help you understand how your current plans are changing, like Medicare.gov and Annual Notice of Change (ANOC) letters.
Troy Baccus, Medicare Life Group owner, suggests using Medicare.gov reports to check for changes in your Prescrption Drug Plan (PDP):
“The best thing you can do to prepare for AEP is run a new prescription drug plan report on Medicare.gov. You'll want to wait until at least October 1 to run the report and make sure you are running the report for the year 2021 (it may default to the current 2020). Running a prescription drug plan report will help you confirm your current plan is still your best option for 2021. If not, you can usually enroll in the another plan directly from the Medicare.gov website.”
Danielle K. Roberts, Boomer Benefits founder, suggests reading the Annual Notice of Change letter:
“Review your Annual Notice of Change letter from your current Part D or Medicare Advantage carrier. You will receive this by mail in September. Look for what is changing that might affect you. Is the premium going up? Have your copays substantially increased? Are they dropping any of your important medications? If you find something you don’t like, then you have an opportunity to make a change during the upcoming OEP that begins on October 15th.
Make a list of all your current medications, including dosage and frequency. You can enter these into the Plan Finder Tool on Medicare.gov website beginning in October. This will help you to search for plans that you know will cover your necessary medications.”
Because Medicare Advantage plans are privately operated by companies, companies can release new plans every year that can be a better option than your current plan.
“New Medicare Advantage plans may be available in 2021 that provide superior coverage to your current plan. The easiest approach to review your Medicare Advantage plan is speaking with an independent agent. Just make sure they've got your best interest in mind and aren't looking to make a quick sale (we recommend checking out their Google reviews, if possible),” suggests Baccus.
Coverage and access to your doctors are some of the most important things you need to double-check for your Medicare plans. To be clear, you can always see any doctor you like, but the cost-sharing available from your plan based on what plans your doctor accepts will affect how high your health care expenses are.
“Reviewing your plan every AEP is important. Not only will you want to make sure your current plan will remain your best option for prescription coverage in 2021, but you'll also want to confirm your doctor will remain in network,” says Baccus.
When checking your coverage, it’s a good idea to do your own research instead of relying on third-party information.
“Please do not take a salesperson’s word for your network coverage, call your providers and ask – “will you be taking this specific plan next year?” Why specific? Because some companies have multiple plans, and your provider may not take them all. Going to medicare.gov is a safe recourse to get the facts,” recommends John Hill, President of Gateway Retirement.
Each state has federally funded programs to help people pay their Medicare premiums, typically for Original Medicare. If you qualify and apply, you may be eligible to participate in some of these Medicare Savings Programs.
“During enrollment, be sure to look into the various savings programs available that can help pay for premiums, out-of-pocket costs, prescription costs and more. There are a number of services available and utilizing them can help you save money,” suggests Michael Stahl, HealthMarkets Executive Vice President and Chief Marketing Officer.
If you’re new to Medicare or want help evaluating plans, meeting with an independent agent can be a smart move.
“I always stress the importance of sitting down with a licensed, non-biased insurance agent who can provide information on Medicare, what is or is not covered, and pricing so you can be informed when it comes time to make decisions during enrollment and choosing your Medicare provider(s),” says Stahl.
While experienced and knowledgeable agents can offer valuable insight and assistance with Medicare plans, it’s important to find a trustworthy one.
“Seniors should find a solid broker with a consistent track record of providing value in the senior community and giving unbiased advice,” says Christopher Westfall, Sr, Senior Savings Network founder.
Looking at client reviews and taking recommendations from friends can help you find a reliable agent. Beyond considering reviews, Medicare has rules regarding what insurance agents selling Medicare can and can't do when working with clients. Understanding these can help you identify good agents.
Knowing that you’re getting good advice can be difficult to determine, especially if you’re not familiar with Medicare. If you want to be an informed decision-maker, it’s worthwhile to do your own research.
“Do your own research rather than only relying on information from insurance agents. There are quality rating systems online and free resources from your state’s Senior Health Insurance Program,” advises Byck.
Understanding your health care expenses and coverage levels from this year will help you forecast costs for next year. It will also help you determine if it’s best to stick to your current plan or if another Medicare plan would be better.
It’s also essential to be aware of any changes to current plans for next year. Knowing these changes will also help ensure that you enroll in the coverage you need in 2021.
Working with a good agent can also help you understand your options and make an informed choice. Even working with an agent, do your own research so that you can ask these important questions and get the information you need to make the best choice for your health plan.
Sign up below to receive a monthly newsletter containing relevant news, resources and expert tips on Health Insurance and other products and services.